Provider Demographics
NPI:1548230212
Name:STAHLMAN, MATTHEW BLAKE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:BLAKE
Last Name:STAHLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1400 N IH 35
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-1926
Mailing Address - Country:US
Mailing Address - Phone:512-324-8300
Mailing Address - Fax:512-324-8301
Practice Address - Street 1:1301 W 38TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1000
Practice Address - Country:US
Practice Address - Phone:512-324-3440
Practice Address - Fax:512-406-6513
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9428207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00837346OtherRAILROAD MEDICARE
TX144427507Medicaid
TX8ET504OtherBCBS
TX8CN833OtherBCBS
TX144427508Medicaid
TX080142147OtherRAILROAD MEDICARE
TX144427506Medicaid
TX144427509Medicaid
TX328256YL9XMedicare PIN
TXH37535Medicare UPIN
TX328256YMGJMedicare PIN
TX144427507Medicaid
TX080142147OtherRAILROAD MEDICARE